Method and apparatus for reducing x-ray exposure

ABSTRACT

The present invention pertains to an apparatus and method for adaptive exposure in imaging systems. An x-ray source for producing x-ray radiation and an x-ray detector for measuring amount of x-ray radiation passing through the human patient and striking the detector can be used. A tomographic image of the human patient or a tomosynthetic image of the human patient can be generated. Region of interest filtering and equalization filtering can be utilized. Filtering can be accomplished with a mechanical shield or shutter or with electronic control of the x-ray source.

RELATED U.S. APPLICATION

This application is a continuation application claiming priority fromthe co-pending U.S. non-provisional patent application Ser. No.13/304,030, Attorney Docket Number TRT-4, entitled “METHOD AND APPARATUSFOR ADAPTIVE EXPOSURE IN X-RAY SYSTEMS,” with filing date Nov. 23, 2011,which claims priority to U.S. provisional patent application Ser. No.61/417,396, Attorney Docket Number TRT-4, entitled “Method and Apparatusfor Adaptive Exposure in X-ray Systems,” with filing date Nov. 26, 2010,both of which are hereby incorporated by reference in its entirety.

STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH AND DEVELOPMENT

The U.S. Government may have a paid-up license in this invention and theright in limited circumstances to require the patent owner to licenseothers on reasonable terms as provided for by the terms of Grant Nos.1RC1HL100436-01 awarded by the National Institute of Health (NIH).

FIELD OF THE INVENTION

The present invention pertains to imaging systems. More particularly,the present invention pertains to region of interest filtering andequalization for x-ray imaging systems.

BACKGROUND

Many medical imaging procedures utilize x-ray radiation because x-raysare of energies, or wavelengths, that can penetrate most human tissuebut are also absorbed or scattered to differing degrees by relativelydense tissues or organs and by bone. This property is useful as therelative intensity of x-rays emerging from a given irradiated region ofa patient will correspond to the “x-ray density,” i.e. the propensity toattenuate x-rays, of the internal structures within that region.Collected by an x-ray detector or simply incident on a fluorescentscreen or x-ray film, emerging x-rays can be used to image the internalstructures of the region. Furthermore, implements such as catheters maybe inserted into a patient for surgical purposes and be tracked usingx-ray imaging, or x-ray dense fluids may be injected into patients'veins so that blood vessel networks can be highlighted in subsequentx-ray images.

Some x-ray imaging procedures irradiate the patient for only a shortperiod of time, as less than a second may be required to collect enoughintensity data for a single x-ray image. However, some x-ray imaging arecompleted on a continuous basis such that a real-time video is generatedfor fluoroscopy and other image-guided procedures. Many surgeries,including the placement of stents and other cardiac procedures, havebecome much safer and requiring of significantly less recovery timesince real-time x-ray imaging systems have enabled less invasiveprocedures.

While x-ray imaging is widely used for the aforementioned reasons,health risks associated with excessive exposure to high energyradiation, including x-rays, are recognized. The interaction ofradiation with human cells and tissues may induce breakages or mutationswhich can develop into cancers over time. The probability of this typeof cellular damage may be relatively insignificant from the exposurenecessary to take a single image as may be necessary to analyze a brokenbone, but may become less insignificant for patients who undergorelatively lengthy image-guided procedures, require multiple CAT scans,or undergo other multi-frame x-ray imaging procedures. Furthermore,cumulative amounts of scattered x-ray radiation may pose health risksfor medical personnel attending x-ray imaging procedures on a regularbasis.

Precautions taken in medical settings against significantly increasingindividuals' cancer risk through x-ray exposure have included attachingcollimation devices to x-ray sources which attenuate x-rays travellingin directions away from the region to be imaged and providing physicalshielding for attendant personnel. Use of non-conventional x-ray imagingconfigurations such as inverse geometry systems have been explored tolower the overall amount of x-ray exposure necessary to obtaingood-quality x-ray images by reducing scatter noise or other factorsthat degrade image quality.

However, existing precautions do little to tailor the amount of x-rayradiation being used during an imaging procedure to the specificpatient, or regions within the patient, to reduce the amount ofradiation exposure. What is needed is an imaging system capable ofproducing rapid high quality images while reducing the amount ofradiation exposure.

SUMMARY

In one embodiment, an x-ray imaging system for imaging a human patientis provided with an x-ray source for producing x-ray radiation, an x-raydetector for measuring amount of x-ray radiation passing through thehuman patient and striking the detector, a controller for selecting aregion of interest in the human patient and a filtering device coupledto the controller and x-ray source configured to reduce x-ray radiationto areas outside the region of interest in the patient. The filteringdevice can be an x-ray source controller for reducing amount of x-rayradiation generated by the x-ray source. The x-ray imaging system caninclude an x-ray source controller coupled to the x-ray sourceconfigured to limit x-ray radiation to a second region of interest inthe human patient below a specified amount or less or an x-ray sourcecontroller coupled to the x-ray source configured to terminate deliveryof x-ray radiation to an area in a second region of interest in thepatient when x-ray radiation to the area reaches a predeterminedthreshold amount.

In another embodiment, an x-ray imaging system for imaging a humanpatient is provided with an x-ray source for producing x-ray radiation,an x-ray detector for measuring amount of x-ray radiation passingthrough the human patient and striking the detector, and a filteringdevice coupled to the x-ray source configured to limit x-ray radiationto the detector to a specified amount and less. The filtering device canbe a shield or can be configured to limit x-ray radiation to a region ofinterest in the human patient to a second specified amount and less.

In another embodiment, a method for producing an x-ray image of a humanpatient is provided: producing x-ray radiation from an x-ray source,selecting a region of interest in the human patient, reducing x-rayradiation to areas outside the region of interest in the patient, andmeasuring amount of x-ray radiation passing through the human patientand striking a detector. X-ray radiation can be limited to a secondregion of interest in the human patient to a minimum amount required toachieve a specified signal-to-noise ratio for the x-ray image or aspecified resolution for the x-ray image. X-ray radiation to a secondregion of interest in the human patient can be limited to a specifiedamount and less. Delivery of x-ray radiation to an area in a secondregion of interest in the patient can be terminated when x-ray radiationto the area reaches a predetermined threshold amount. Exposure of x-rayradiation can be selected for each of a plurality of projections of theregion of interest.

In another embodiment, x-ray radiation is produced from an x-ray source,amount of x-ray radiation passing through the human patient and strikinga detector is measured and x-ray radiation to the detector is limited toa specified amount and less. A region of interest in the human patientcan be selected and x-ray radiation to the region of interest in thehuman patient can be limited to a second specified amount and less.

These and other objects and advantages of the various embodiments of thepresent invention will be recognized by those of ordinary skill in theart after reading the following detailed description of the embodimentsthat are illustrated in the various drawing figures.

BRIEF DESCRIPTION OF THE DRAWINGS

The present invention is illustrated by way of example, and not by wayof limitation, in the figures of the accompanying drawings and in whichlike reference numerals refer to similar elements.

FIG. 1 is a diagram showing an exemplary x-ray imaging system of oneembodiment of the present invention.

FIG. 2 is a diagram showing a portion of an exemplary scanning-beamx-ray imaging system of one embodiment of the present invention.

FIG. 3 is a diagram illustrating one embodiment of the present inventionin which a region of interest has been defined within the patientvolume.

FIG. 4 is a table displaying contrast-to-noise improvement for differentiodine concentrations for procedures in which iodine has been used as acontrast agent.

FIG. 5 is a plot illustrating a manner of equalization filtration of oneembodiment of the present invention.

DETAILED DESCRIPTION

Reference will now be made in detail to embodiments of the presentinvention, examples of which are illustrated in the accompanyingdrawings. While the invention will be described in conjunction withthese embodiments, it will be understood that they are not intended tolimit the invention to these embodiments. On the contrary, the inventionis intended to cover alternatives, modifications and equivalents, whichmay be included within the spirit and scope of the invention as definedby the appended claims. Furthermore, in the following detaileddescription of embodiments of the present invention, numerous specificdetails are set forth in order to provide a thorough understanding ofthe present invention. However, it will be recognized by one of ordinaryskill in the art that the present invention may be practiced withoutthese specific details. In other instances, well-known methods,procedures, components, and circuits have not been described in detailas not to unnecessarily obscure aspects of the embodiments of thepresent invention.

By way of brief overview, embodiments of the present invention willpresent manners by which the exposures of x-rays to at least one personcan be minimized by region of interest filtering, or by one or more ofthe methods described herein or electronic region of interest filtering;equalization filtering, or by one or more of the methods describedherein or utilizing electronic equalization filtration, or digitalequalization filtration; modification of the x-ray spectrum, or by oneof the methods described herein; and improving contrast using an energyresolving detector, or by the method described herein.

FIG. 1 is a diagram showing an exemplary x-ray imaging system of oneembodiment of the present invention. An imaging system is disclosed inU.S. Pat. Nos. 5,651,047, 6,183,139, 6,198,802 and 6,234,671, entitled“Maneuverable and Locateable Catheters,” “X-Ray Scanning Method andApparatus,” “Scanning Beam X-Ray Source and Assembly,” “X-Ray Systemwith Scanning Beam X-Ray Source Below Object Table,” respectively, allof which are incorporated herein by reference in their entirety. Imagingsystem 3 can further comprise source 10 and detector 110. Source 10 canbe a scanning-beam x-ray source or carbon nanotube x-ray source,discrete cathode x-ray sources, or other discrete x-ray sources. In oneembodiment of the present invention source 10 can be a scanning beamx-ray source.

Use of scanning beam x-ray source 10 allows for utilization of a reversegeometry configuration for imaging system 3. In a reverse geometryconfiguration, a smaller detector can be used whereas a point sourcerequires a much larger detector. The area of the detector can be 2, 3,4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19 or 20 percentof the area of the maximum field of view for given source configurationand detector distance from patient or any percentage in between suchpercentages or any range of percentages in between such percentages. Ina reverse geometry configuration, the detector can also be locatedfarther away from the patient than a detector with a point x-ray source.With a point x-ray source, the size of the detector required for a givenmaximum field of view size increases with the distance of the detectorfrom the patient. The already large detector required with a point x-raysource becomes even larger with increasing distance. With a scanningx-ray source in a reverse geometry configuration, the size of thedetector required for a given maximum field of view size decreases withthe distance of the detector from the patient. Thus, the detector forscanning x-ray source 10 can be located with a distance from the patientof 1.3 m, 1.4 m, 1.5 m, 1.6 m 1.7 m, 1.8 m, 1.9 m, 2 m, 2.1 m 2.2 m, 2.3m, 2.4 m, 2.5 m or any distance in between such distances or any rangeof distances in between such distances. FIG. 2 is a diagram showing anexemplary scanning-beam x-ray imaging system of one embodiment of thepresent invention. X-ray source 10 can be the x-ray source describedmore fully in U.S. Pat. Nos. 5,682,412 and 6,198,802, entitled “X-RaySource” and “Scanning Beam X-Ray Source and Assembly” respectively, bothof which are hereby incorporated herein by reference in their entirety.

X-ray source 10 can comprise deflection yoke 20 under the control ofscan generator 30. Deflection yoke 20 can comprise one or more magneticfocus or deflection coils. The magnetic focus or deflection coils can bemade with insulated electrical wire wound around a core. The core can beferrite, steel, iron or other magnetic alloy. An electron beam 40generated within x-ray source 10 can be scanned across target 50 withinx-ray source 10 in a predetermined pattern. Target 50 can be a groundedanode target. The predetermined pattern can be a raster scan pattern, aserpentine (or “S” shaped) pattern, a spiral pattern, a random pattern,a gaussian distribution pattern centered on a predetermined point of thetarget, or such other pattern as may be useful to the task at hand. Theserpentine (or “S” shaped) pattern can eliminate the need in a rasterscan pattern for horizontal “fly back.”

The images can be acquired, including reconstruction, and the exposurerates can be optimized using the methods described above and below,rapidly enough to create a continuous, real time video representation ofthe motion of the object, including organs such as one or more of thelungs, the heart, or other organs, or instruments, such as catheters orstents, or implantable objects such as valves, in real time.

The scanning-beam imaging system described herein can be used togenerate a set of sequential planar images which can then be used toform a tomograph or a three dimensional display of the object 80. Animage set can be analyzed to produce a three dimensional imageconsisting of a series of images at various depths by re-analyzing thedata set with various values corresponding to planes of interest in theobject 80.

FIG. 3 is a diagram illustrating one embodiment of the presentinvention. In FIG. 3 electron beams 1301 a and 1301 b impinge on focalpoints 1303 a and 1303 b of target 1307, and electron beams 1302 a and1302 b impinge on focal points 1304 a and 1304 b of target 1307. Here,for simplicity, only one row of focal spots is shown, whereas in apreferred embodiment the target may be made of several rows of focalspots. When the electron beams 1302 a and 1302 b strikes target 1307 atfocal spots 1304 a and 1304 b, x-ray beams 1309 a and 1309 b are createdand measured by detector(s) 1308. An object, e.g. a human patient, to beimaged contains some region of interest 1306. Region of interest 1306 isshown here for simplicity as a single region, but in actuality could be2, 3, 4, or more distinct regions of interest. In order to minimize thedose to the patient and reduce exposure to medical personnel, only thefocal spots 1304 a and 1304 b and those between them are illuminated bythe full electron beams 1302 a and 1302 b. As focal spots 1303 a and1303 b would expose an area outside of region of interest 1306, patientdose is reduced by reducing electron beams 1301 a and 1301 b orredirecting the beams away from focal spots 1303 a and 1303 b. Thisprocess is referred to as region of interest filtering. It can be morespecifically described as digital or electronic region of interestfiltering, as the definition of at least one region of interest 1306does not require the placement of mechanical components such asshutters, but instead is implemented by electronically controllingelectron beams 1301 a, 1301 b, 1302 a and 1302 b.

In an embodiment of the present invention, detector 1308 is an energyresolving detector with two or more energy bins, preferably 10 or lessbins, more preferably 5 or less bins, and most preferably 2 bins, andthe contrast-to-noise ratio is optimized for a given contrast medium byweighting the number of detected x-rays in each bin by using theexpression

${w(E)} = \frac{1 - ^{{- {\lbrack{{\mu_{c}{(E)}} - {\mu_{b}{(E)}}}\rbrack}} \cdot d}}{1 + ^{{- {\lbrack{{\mu_{c}{(E)}} - {\mu_{b}{(E)}}}\rbrack}} \cdot d}}$

as the weighting factor, wherein d is the thickness of the contrastmedium, μ_(c)(E) is the energy dependent attenuation coefficient of thecontrast medium, and μ_(b)(E) the attenuation coefficient of thebackground.

In another embodiment of the present invention, the exposure to x-raysof at least one person is optimized by modifying target 1307, andthereby modifying the shape of the x-ray energy spectrum, to best matchthe x-ray energy spectrum to one or more of: the needs of the procedureto be performed; the properties of the subject being imaged; theproperties of the target organ to be imaged; any instrument that will beused during the procedure; and any contrast agents used during theprocedure. The modification of target 1307 can involve the use ofmaterials, wherein those materials are chosen from materials includingbut not limited to tungsten, copper, aluminum, beryllium, lead, rareearth elements including but not limited to gadolinium, and alloys ormixtures thereof.

It is an aspect of an embodiment of target 1307 that target 1307comprises a tungsten layer in contact with the vacuum layer into whichelectron beam 1302 a and 1302 b impinges and creates x-rays 1309, andwherein the x-ray spectrum is modified by one or more layers of anadditional material or materials. A modified target 1307 can comprise aberyllium sheet onto which a film of tungsten is deposited, whileberyllium is in contact with a thin layer of cooling water, which isfollowed by thin aluminum sheet, and wherein the procedure may utilizeiodine as a contrast agent, and wherein the procedure may be a cardiacintervention. FIG. 4 is a table displaying contrast-to-noise improvementfor different iodine concentrations.

In a further embodiment, there is at least one additional layercomprising at least one rare earth metal between the tungsten film andthe beryllium sheet, where the at least one rare earth metal cancomprise gadolinium.

There are many ways that region of interest 1306 can be defined. In apreferred embodiment, a healthcare provider is presented with an image(a recently acquired frame) from which to define region of interest 1306or multiple regions of interest. The image from which the health careprovider defines region of interest 1306 and other regions of interestthat will be exposed to x-rays can be the entire field of view of thesystem, or any subset thereof, including a previously defined region ofinterest. The health care provider can define the region(s) of interestin many ways, but in a preferred embodiment the region(s) of interest(s)are defined by the health care provider drawing the region on a displaydevice, preferably using a dedicated stylus but in other embodimentsusing a finger or any other object.

In another embodiment of the present invention, the control and imagingportions of the apparatus are used to automatically define a region ofinterest that is optimal for the procedure to be performed, usingmethods chosen from a list including but not limited to: identifying anorgan of interest, identifying a tumor, utilizing image data takenpreviously of the patient, using an algorithm that uses patient dataincluding but not limited to height, weight, body mass index, age, sex,race, medical status or conditions, chest size, and/or length of arms orlegs.

To further reduce the x-ray dose delivered to the patient as well asreduce the exposure to x-rays of health care providers, one embodimentof the present invention determines the minimum amount of x-rayradiation required to make a reconstructed image with a sufficientsignal-to-noise ratio and resolution for the procedure to be performed,in at least one region of the object, preferably in more than oneregion, e.g. in region 1311 a and region 1311 b. Further, the apparatusthen limits the x-ray dose to regions 1311 a or 1311 b to that minimumrequired amount. This is referred to herein as equalization filtering.

As shown in FIG. 3, there are two separate regions 1311 a and 1311 b towhich equalization filtering may be applied. To apply equalizationfiltration, the x-ray absorbance of regions 1311 a and 1311 b aredetermined by exciting focal spots 1304 a and 1304 b with electron beamsof known qualities. This causes the formation of x-ray beams 1309 a and1309 b which pass through regions 1311 a and 1311 b and are subsequentlydetected by detector 1308. Based on this measurement, electron beams1302 a and 1302 b are modified in a way that reduces the total x-raydose to regions 1311 a and 1311 b to only that needed to achieve thesignal-to-noise ratio required at the image resolution necessary tocomplete procedure being performed. The adjustable properties ofelectron beams 1302 a and 1302 b may be chosen from a list including butnot limited to voltage, current, or duration. In a preferred embodimentthe electron beams are raster-scanned over the focal spots on target1307, dwelling on each targeted focal spot for a predetermined amount oftime. The reconstructed image is formed from 2 or more raster scans ofthe electron beams over target 1307, and the equalization filtration isimplemented by adjusting the number of times the electron beams dwell oneach focal spot 1304 a and 1304 b. This method is herein referred to asdigital equalization filtration.

In one embodiment of the present invention, the dose of x-rays to apatient is minimized by determining the amount of x-ray radiationdetected by one or more pixels in one or more detectors, e.g. detector1308, during an image acquisition and terminating the delivery ofradiation to a region of the patient, e.g. region 1311 a or 1311 b,based on a threshold amount of measured x-ray radiation detected by theone or more detectors or detector pixels. In the digital equalizationfiltration method described above, this is implemented by measuring theamount of x-rays being detected by at least one detector or at least onepixel in at least one detector and during dwells of electron beam 1302 aand 1302 b on a focal spot 1304 a and 1304 b; determining a sum total ofx-rays detected during one or more dwells of electron beam 1302 a and1304 b on a focal spot 1304 a and 1304 b; and skipping future dwells tobe performed on that focal spot 1304 a and 1304 b during that imageacquisition when the sum total exceeds a predetermined threshold amount.This process is repeated for each focal spot 1304 a and 1304 b to beused. This embodiment has the advantage of a high signal-to-noise ratiofor the determination of whether the signal measured has exceeded thethreshold value.

In another embodiment of the present invention, the amount of x-raysdetected during the first dwell of x-ray beam 1302 a and 1304 b on eachfocal point 1304 a and 1304 b is used to then compute the expectednumber of dwells required to measure a sufficient amount of x-rays tocreate an image of the required signal-to-noise and resolution, and thatnumber of dwells is used during the imaging process. This determinationis repeated for each focal spot to be used. This method has theadvantage of being less computationally intensive but suffers from lowersignal-to-noise than the previous embodiment.

Due to software or hardware limitations, it may be preferable to limitthe number of changes in the number of dwells between subsequent focalspots during the raster scan of target 1307. This can be achieved by analgorithm that allows a range of values for the threshold value, forexample by putting in some hysteresis that stops the number of dwellsfrom bouncing up and down due to noise, for example Poisson or “shot”noise, in the number of x-rays arriving during the dwells during theraster scan.

It is preferable to perform equalization filtration in real time, i.e.during each image acquisition, by adjusting the exposure time or someother property of the electron beam to optimize the number of x-raysemitted from each focal spot as the imaging system runs. This has theadvantage of not only minimizing the x-ray dose to the patient but alsoproviding an optimized reconstructed image for each acquisition, forexample each frame in a video image, by removing artifacts and issuesdue to, for example, heart rate and/or respiratory rate. However, thepreviously discussed embodiment of the present invention that minimizesthe dose of x-rays to a patient by determining the amount of x-rayradiation detected by one or more detectors or pixels in one or morepixelated detectors during an initial image acquisition, and based onthat measurement, delivering an optimal, reduced, amount of x-rayradiation to a region, e.g. region 1311 a or 1311 b, of the patientduring one or more subsequent image acquisitions has the advantage ofbeing less computationally intensive.

Other data and methods can be used to implement and refine equalizationfiltration, using methods chosen from a list including but not limitedto: identifying an organ of interest, identifying a tumor, utilizingimage data taken previously of the patient, using an algorithm that usesa predefined model of a region to be imaged and optionally includespatient data including but not limited to height, weight, body massindex, body fat percentage, age, sex, race, medical status orconditions, and/or size of a body region to be imaged, including but notlimited to thickness, length, height, volume, and/or circumference,including but not limited to the size of the subjects chest, abdomen,waist, neck, head, arms, or legs, and using this information to modifythe amount of radiation delivered to the various regions to be imaged.These techniques are preferably combined with the digital equalizationfiltration embodiments described above and/or combined with theelectronic region of interest filtering described above.

In one embodiment of the present invention, image equalization isimplemented using information about a reconstructed image, said imagebeing a previously acquired image, e.g. an earlier frame. In thisembodiment, it is preferable that the previous image be a recentlyacquired image, ideally in the range of 1 to 20 images previouslyacquired, and may be chosen from 1, 2, 3, 4, 5, 10, 15, or 20 imagesprevious. It may be advantageous to utilize only image data from asubset, or region, within the final reconstructed image.

In another embodiment of the present invention, equalization filtrationis implemented using a preliminary, interim reconstruction generated byx-rays detected from one or more detectors or one or more pixels in oneor more detectors during a subset of the final dwell time on one or morefocal spots. It is preferable that the subset of the final dwell timeincludes the first dwell and may optionally include data from the firstand second; first, second, and third; first, second, third, or fourth;or any other combinations of the available dwells, including but notlimited to during the first 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15,16, 17, 18, 19, or 20 dwells, or during the first ¼, ⅓, ¼, ⅔, or ¾ ofthe maximum number of dwells.

For digital equalization filtration, it is preferred that every time theelectron beam dwells on focal spot 1304 a or 1304 b, the length of timeit dwells on focal spot 1304 a or 1304 b is characterized by apredefined dwell time chosen from zero milliseconds (if region ofinterest filtering is simultaneously used and has determined that focalspot 1304 a or 1304 b does not illuminate the region(s) of interest) toa predetermined non-zero dwell duration. The total dwell time for focalspot 1304 a or 1304 b may then be the predetermined non-zero amount oftime multiplied by the number of non-zero dwell time dwells for focalspot 1304 a or 1304 b, and the dwell time for other focal spots may besimilarly determined. The amount of delivered x-ray radiation can beadjusted by adjusting the number of non-zero duration dwells. Theproperties of the electron beam including but not limited to voltage,current, focusing, or dwell time per dwell can be the same for all focalspots used in target 1307, but these may also be adjusted to implementor refine equalization filtration.

For the digital equalization filtering described herein, it is preferredto reconstruct each image based on both the amount of x-ray radiationdetected by the at least one pixel of the at least one detector 1308,and the number of non-zero dwell time dwells for each correspondingfocal spot 1304 a and 1304 b. In an embodiment of the present invention,the amount of radiation detected by the at least one detector 1308summed over the total number of dwells per image is divided by thenumber of dwells or the total dwell time of the electron beam 1302 a or1304 b on the corresponding focal spot 1304 a or 1304 b and thisnormalized detected x-rays per dwell or per unit time is used insubsequent image reconstruction.

X-ray detector 1308 can include any usable technology, and may be chosenfrom a list including but not limited to: a photon counting detector, acharge-integrating detector, or an energy resolving detector.

In an embodiment of the present invention, detector 1308 is a photoncounting detector, and the dwell time and/or the number of fixed dwellsis modified by truncating the exposure of focal spot 1304 a and 1304 bto electron beam 1302 a and 1304 b when the number of photons detectedby detector 1308 exceeds a pre-determined threshold number, andsimilarly truncated for other focal spots.

In an embodiment of the present invention, detector 1308 and/or otherdetectors are photon counting detectors or more preferably energyresolving detectors, and the dwell time and/or the number of fixeddwells is modified by truncating the exposure of focal spot 1304 a and1304 b to electron beam 1302 a and 1304 b when the number of photonsdetected by detector(s) 1308 exceeds a pre-determined threshold numberwherein the threshold number is modified based on one or both of: thenumber of photons detected in at least one energy bin by at least onepixel or detector 1308 during a previously dwelled upon different focalspot or focal spots; or the number of dwells before the threshold wasreached during exposure of a previously dwelled upon different focalspot or focal spots during a given raster scan. This has the advantagethat the threshold can be modified to minimize the number of changes inthe number of dwells between subsequent focal spots in the scan oftarget 1307, simplifying the mechanism and the method, and/or allowingit to run faster.

Under an alternative embodiment of the present invention, x-ray dosageand radiation on object 80 or the patient and attending staff can befurther reduced by use of adaptive methods and apparatus. Imaging system3 may or may not be used in conjunction with a radiation source and mayor may not be part of a radiation therapy system. X-ray imaging of thehuman body involves x-rays penetrating through different regions withhighly varying attenuations; the intensity of x-rays reaching a detectordepends on the amount the x-rays from a source were scattered andabsorbed within the patient volume. Areas of the x-ray image can beoverexposed with the result that object 80, the patient and attendingstaff can be exposed to unnecessary dose or x-ray radiation.

The adaptive methods and apparatus of one embodiment of the presentinvention can reduce x-ray dose and radiation and can be utilized forreal-time x-ray imaging. Rather than acquiring the full-field image witha single exposure, imaging system 3 can use many exposures orprojections of small areas of object 80 to generate the image, thenumber of exposures or projections can be as high as thousands. For a7-inch field of view, up to 9,000 exposures or projections can be used.Multiple exposures or projections are possible through use of ascanning-beam x-ray source or a multi-pixel carbon nanotube x-ray sourceor discrete cathode x-ray source or other multi-pixel x-ray sources assource 10. Each exposure or projection can significantly overlap withneighboring exposures or projections, thus the exposures or projectionscan be redundant. Rather than using the same exposure for everyprojection, imaging system 3 exposes every projection with justsufficient exposure to obtain the desired image quality. For example,lungs may be a body part requiring less exposure to obtain an image of agiven quality, as their attenuation characteristics permit thepenetration of a relatively large percentage of incident x-rayradiation. Therefore, in an embodiment of the present inventionutilizing a scanning-beam x-ray source or a multi-pixel carbon nanotubex-ray source or discrete cathode x-ray source or other multi-pixel x-raysources, imaging system 3 may expose the lung to less radiation thanother body parts that are relatively x-ray opaque, such as the heart,and still achieve sufficient image quality. Imaging system 3 can adjustexposures and radiation by using different tube voltages, beam currents,exposure times, repetitions of fixed-length exposures, or thecombination of the former. One setting can be 120 kV tube voltage at 17kW power and another setting can be 80 kV tube voltage at 9 kW power.Reducing the exposure or radiation is not the only benefit. Imagingsystem 3 also can define preselected regions of interest for increasedimage quality and other regions with lower image quality. Thus, regionsof interest that require high image quality, can receive more exposurethrough increased repetition of fixed-length exposures of that region,different tube voltages, beam currents, exposure times, or thecombination of the former.

Under an alternative embodiment of the present invention, source 10 canbe a scanning-beam X-ray source. Electron beam 40 can be swept acrossX-ray target 50 and dwells at distinct focal spot 60 positions for apredetermined exposure time, which depends on the frame rate and thesize of field of view. At a frame rate of 15 fps (7″ mode field ofview), the exposure time is 8 μsec. This exposure time is broken into 1μsec illuminations (rescans) separated in time. For given materialselection and dimensions of x-ray target 50, use of 1 μsec illuminationscan keep the temperature of x-ray target 50 below desired maximums(maximums being set by the potential of the target to “burn out” whenoverheated by the incident beam in a localized region). Thus, everyfocal-spot position is rescanned several times. Different size or aspectratio of field of view can also be used, 5″×5″,5″×10″, etc, or, 6″, 7″,8″, 9″, 10″, 11″, 12″, 13″, 14″ or 15″.

Imaging system 3 can utilize equalization or region of interestfiltration or both. For both equalization or region of interestfiltration, offline implementation or real-time implementation can beutilized. Imaging system 3 can acquire images from up to 9,000 differentfocal-spot positions for each full-field image. Each acquisition can berepeated up to 8 times (8 rescans). With 7″ field of view, this resultsin a frame rate of 15 fps. Alternatively, each acquisition can berepeated 2, 3, 4, 5, 6, 7, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19 or20 times (rescans). Imaging system 3 can aggregate the rescans or it cansave each rescan separately (rescan images). Each rescan can be saved asa separate file and can be buffered. Alternatively, the rescans can beaggregated immediately.

Under an alternative embodiment of the present invention, imaging system3 can implement equalization filtration using separate or aggregatedrescan images. In this embodiment, imaging system 3 may first determinea target number of photons per detector image. It may then determine thenumber of photons in the rescan image(s) and aggregate rescan imagesuntil at least the target number of photons is reached or all 8 rescansare added. This procedure yields a “rescan map” detailing how manyrescans are needed per focal spot position and a modified detector imagefile that can be reconstructed with the reconstruction engine.

Equalization filtration not only saves dose but can be a very effectiveway to compress dynamic range and thereby improve image quality. Aspreviously discussed, equalization filtration can dynamically andautomatically vary the exposure depending on the opacity of the regionexposed. Hence, it can compress the dynamic range by reducing exposuresignificantly in translucent areas such as the lung field and maintainexposure in more opaque regions.

Under another embodiment equalization is performed by variation of thebeam current and the beam current is adjusted according to the fluxmeasured at the detector. Importantly the beam current can start at lowvalues to not saturate the detector even with no attenuator, e.g. nopatient, present. With an attenuator present this low beam current willresult in a very low flux being detected at the detector. Feedbackrelaying detected flux can lead to up-regulation, i.e. increasing, ofthe beam current until desired flux is achieved. The up-regulation canbe done during a single exposure or implemented via rescans.

FIG. 5 is a plot illustrating a manner of equalization filtration of oneembodiment of the present invention. In this embodiment, equalizationfiltration can be implemented by performing the first scan across theentire field of view or part of the field of view. A “main threshold”can be determined to limit exposure in each partial image of eachrescan. Once desired exposure level or threshold has been achieved, thex-ray beam in partial images can be turned off or the x-ray beamsassociated with particular collimator holes can be turned off. Withproper threshold value, partial images or collimator holes receivingexposure above the threshold will be turned off. In this manner, thedynamic range of exposure values can be compressed and dose can besaved. Image quality can be improved by reducing exposure in the lightareas thus reducing the dynamic range.

In FIG. 5, the x-axis, labeled “Collimator Hole” represents the positionof the scanning beam over subsequent apertures in collimation grid 90;it could also be viewed as a temporal axis, where the units of time areequal to the dwell time for a single aperture. The y-axis indicates theamount of x-ray flux emitted from an aperture that reaches detector 110after penetrating some amount of patient volume. It can be seen thataperture 140 will be scanned by beam 40 or otherwise illuminated, i.e.“on,” until the amount of x-ray flux from a given aperture reachingdetector 110 exceeds the main threshold, at which point the electronbeam is switched “off.” If the flux drops below the main threshold, theelectron beam is switched on again, and so forth.

Under an alternative embodiment of the present invention, equalizationfiltration can be done by calculating the rescan map in real time whilethe image is acquired. Implementation of the rescan map allows imagingsystem 3 to perform an equalization filtration scan in hardware, turningon or off the x-ray beam depending on how many rescans are needed. Acomplication is that there may be a hardware limit related to the gridcontrol on the electron beam that limits the number of times that thex-ray beam can be turned on or off (number of switches) during eachimage acquisition frame. Such a limitation results from impedance,resistance, capacitance and inductance characteristics of the hardware.To limit the number of switches, equalization filtration can be modifiedby not only relying on a single threshold but rather considering a bandof target counts, effectively low-pass filtering the rescan map. With asingle threshold as in FIG. 5, imaging system 3 may switch 774 times ormore. With a threshold band of target counts, imaging system 3 couldreduce the number of switches to 548 or some other number below 774 orthe number of switches experienced with a single threshold. Withadjustment of threshold settings in the threshold band, imaging system 3could further reduce the number of switches to 463 or some other numberbelow 774 or the number of switches experienced with a single threshold.

Imaging system 3 can implement equalization filtration using a thresholdband, comprised of an upper maximum threshold and a lower minimumthreshold, of target counts by saving or tracking exposure (flux) foreach area or collimator hole in the rescan map. As imaging system 3performs a scan, when the exposure or flux for an area or collimatorhole increases from a level below a maximum threshold to a level justabove the maximum threshold, the x-ray beam for the area or collimatorhole is turned off. When the exposure or flux for an area or collimatorhole falls below the maximum threshold, the x-ray beam for the area orcollimator hole remains off. When the exposure or flux for an area, orcollimator hole decreases further to a level below a minimum threshold,the x-ray beam for the area or collimator hole is turned on. When theexposure or flux for an area or collimator hole increases above theminimum threshold, the x-ray beam for the area or collimator holeremains on. When the exposure or flux for an area or collimator holeincreases above the maximum threshold, the x-ray beam for the area orcollimator hole will be turned off. At different angles, imaging system3 can save between 33% and 60% dose with an average dose saving of 47%using equalization filtration. Alternatively, dose saving of 41%, 43% or45% of primary photons can be achieved.

If visualized using FIG. 5, the threshold band may appear as ahorizontal line positioned higher on the y-axis than the main thresholdrepresenting the maximum threshold and a horizontal line positionedlower than the main threshold representing the minimum threshold. Thestate of the collimator hole would only switch from “on” to “off” whenthe flux transitioned from below to above the maximum threshold andwould only switch from “off” to “on” when the flux transitioned fromabove to below the minimum threshold.

Under an alternative embodiment of the present invention, equalizationfiltration can be done by calculating the rescan map from a single frameof a real-time video and use it for the subsequent frame. Implementationof the rescan map in this manner allows imaging system 3 to perform anequalization filtration scan in hardware, thus turning on or off thex-ray beam depending on how many rescans are needed. This embodiment canbe used with a single threshold or a threshold band.

Under an alternative embodiment of the present invention, imaging system3 can utilize region of interest filtration, and two or more regions ofinterest can be selected. The first region of interest may maintain fullimage quality, with 8 rescans or the maximum number of rescans, and thesecond region of interest may only be imaged at significantly reducedimage quality, with 1 or 2 rescans or a lower number of rescans thanfull image quality. Outside the second region of interest, the beam mayturned off entirely via electronic collimation or another method. Therescan images can be aggregated based on the selection by the user orbased on automatic or predetermined selection by imaging system 3. Theresulting detector images can be reconstructed and can be evaluated forimage quality and dose savings. The user can toggle between region ofinterest filtration and standard acquisition mode on a frame by framebasis. Collimation can be but does not have to be toggled as well.

Region or regions of interest can be selected by the user or selected byimaging system 3 based on automatic or predetermined selection. Afterselection, imaging system 3 can define and implement region or regionsof interest by deploying a mechanical shield or shutter to blockelectron beam 40 before x-ray target 50 or the x-ray beam after x-raytarget 50. Shield or shutter can be made from tungsten, tungsten copper,tungsten alloy, lead, lead antimony, lead alloy, tantalum, tantalumalloy or other material with a high atomic number. (Materials with ahigh atomic number may successfully shield x-rays more so than materialswith low atomic numbers).

Under an alternative embodiment of the present invention, region orregions of interest can be selected by the user or selected by imagingsystem 3 based on automatic or predetermined selection from a variety ofshapes including without limitation, circle, oval, ellipse, square,rectangle, triangle, polygon and quadrilateral shapes. The region orregions of interest can also be the entire field of view except theregions within the shape selected or the regions excluded by the shape.The size of the region or regions of interest can be any size or rangeof sizes up to the size of the field of view. In one embodiment of thepresent invention, the region of interest is set to the size of a humanheart or one chamber of the human heart and is intended to expose onlythe heart or selected chamber to radiation. In another embodiment of thepresent invention, the region of interest is the size of human ovariesand is intended to exclude radiation from the ovaries.

To implement region of interest filtering, imaging system 3 can performan initial scan across the entire field of view. Alternatively, imagingsystem 3 can utilize a previous saved scan or image. Imaging system 3can also perform one or more rescans across the entire field of view.Imaging system 3 can then perform one or more rescans based on the shapeselected or shape excluded at the size of the region of the interest.The rescan would only involve exposure for some area or collimator holescorresponding to the shape selected at the size of the region ofinterest. The rescan may involve all of the collimator holes within theshape selected or a portion of those collimator holes but would notinvolve areas or collimator holes outside the shape selected. In theexample of a shape excluded, the rescan would only involve exposure forthe area or collimator holes outside the shape excluded at the size ofthe region of interest. Imaging system 3 can also perform one or morerescans based on one or more additional shapes selected or shapesexcluded at one or more sizes of the region of the interest.

Under one embodiment of the present invention, imaging system 3 performsone initial scan and one rescan across the entire field of view, tworescans or one additional rescan across a rectangular region of interestcorresponding to half of a human heart, and eight rescans or sixadditional rescans across a smaller region of interest within therectangular region of interest. The entire field of view receives oneinitial scan and one rescan. The rectangular region of interest receivesone initial scan and two rescans and the smaller region of interestwithin the rectangular region of interest receives one initial scan andeight rescans. Dose savings of up to 82% of the primary photons can beachieved utilizing this region of interest approach.

Under an alternative embodiment of the present invention, the specificregion of interest can vary in position in the field of view over time.The region of interest can be a selected shape (e.g. circle, oval orellipse) of a specified size that follows a contrast agent as it flowsthrough vessels in the heart. The region of interest can beautomatically selected by, for example, following the tip of a catheteror by following the bolus of a contrast medium. The region of interestcan follow the edge of the contrast agent as it moves through vessels inthe heart. The region of interest can also be time-based in a mannerwhich tracks the motion of an organ such as the heart. The region ofinterest can be the area of the field of view experiencing motion.

Alternatively, the region of interest can be calculated by imagingsystem 3. In a tomographic or tomosynthetic application, the user canselect a single plane or multiple planes of interest. The user canselect the region or regions of interest in the selected plane orplanes; the region of interest can be selected by the user in threedimensions. Imaging system 3 can then track the region of interest orregions of interest in following frames by incorporating motion withinthe field of view and calculating the relative position of the region ofinterest or regions of interest.

Under an alternative embodiment of the present invention, equalizationfiltration can be combined with regions of interest to achieve maximaldose savings without detracting from the high image quality desired.

If target 50 includes a tungsten film, x-ray may be emitted through twomechanisms: Bremsstrahlung radiation, a direct results of the suddendeceleration of electrons by collision with heavier target particles,and K-line radiation, a result of incident electrons knocking targetelectrons out of their atomic “K” shell and other target electronsshedding energy to fill these created vacancies. Bremsstrahlungradiation takes on a spectrum of wavelengths and is the primarymechanism by which x-rays are emitted whereas K-line radiation emits aspecific wavelength characteristic to the atomic structure of tungstenor target material and is the less prevalent mechanism.

Under an alternative embodiment of the present invention, the beamhardening filter is brought into close proximity of the tungsten film inx-ray target 50 and emitted K-line radiation can have a similar spatialextent as the primary (Bremsstrahlung) radiation and can be useful forimaging. X-ray target 50 can also have an additional film with a rareearth that has K-lines particularly well suited for imaging.Specifically, the rare earth can provide large contrast in iodine, acontrast medium used in interventional cardiology. Various rare earthscan be used (e.g. Er, Gd, Dy, Sm) with different thicknesses (10 μm to150 μm) and X-ray tube potentials (60 kVp to 90 kVp). A 150 μm layer oferbium in x-ray target 50 at 80 kVp can result in a low dose. The dosecan be 87% of that found with 1 mm iodine using 0.1 mm Copper beamhardening filter, 70 kVp X-ray tube potential and maximum electron beamcurrent of 210 mA. A reduced Er layer thickness of 120 μM can also beused and Er can be used in x-ray target 50. For the beam hardeningfilter the dose can be 96% with 1 mm iodine using 0.1 mm Copper beamhardening filter, 70 kVp X-ray tube potential and maximum electron beamcurrent of 210 mA and for the integrated case it can 89%. Thus, using Erin the target can save 7.5% of the dose compared to using it as a beamhardening filter.

From a dose standpoint, a 150 μM Erbium target can be utilized. Er canbe a significant thermal resistor that slowed the time to equilibriumtemperatures significantly. A more convenient measure of time toequilibrium is the time to maximum temperature in the Be layer. With 1mm iodine using 0.1 mm Copper beam hardening filter, 70 kVp X-ray tubepotential and maximum electron beam current of 210 mA, this time can be25 μs and for a 20 μM layer of Er the time can almost double. At thetarget thickness of 150 μm, the time can increase to 520 μs. Long timesto equilibrate can lead eventually to overheating of x-ray target 50.

The foregoing descriptions of specific embodiments of the presentinvention have been presented for purposes of illustration anddescription. They are not intended to be exhaustive or to limit theinvention to the precise forms disclosed, and many modifications andvariations are possible in light of the above teaching. The embodimentswere chosen and described in order to best explain the principles of theinvention and its practical application, to thereby enable othersskilled in the art to best utilize the invention and various embodimentswith various modifications as are suited to the particular usecontemplated. It is intended that the scope of the invention be definedby the claims appended hereto and their equivalents.

What is claimed is:
 1. A method for producing an x-ray image of a humanpatient comprising: producing x-ray radiation from an x-ray source;selecting a region of interest in said human patient; controlling saidx-ray source to reduce said x-ray radiation to areas outside said regionof interest in said patient; and measuring amount of said x-rayradiation passing through said human patient and striking a detector. 2.The method of claim 1 further comprising: selecting a second region ofinterest in said human patient.
 3. The method of claim 2 furthercomprising: reducing said x-ray radiation to areas outside said regionof interest and said second region of interest.
 4. The method of claim 2further comprising: reducing said x-ray radiation to said second regionof interest in said human patient.
 5. The method of claim 1 furthercomprising: limiting said x-ray radiation to said region of interest insaid human patient to a minimum amount required to achieve a specifiedsignal-to-noise ratio.
 6. The method of claim 1 further comprising:limiting said x-ray radiation to said region of interest in said humanpatient to a minimum amount required to achieve a specified resolution.7. The method of claim 1 further comprising: limiting said x-rayradiation to areas outside said region of interest in said human patientto a minimum amount required to achieve a specified signal-to-noiseratio.
 8. The method of claim 1 further comprising: limiting said x-rayradiation to areas outside said region of interest in said human patientto a minimum amount required to achieve a specified resolution.
 9. Themethod of claim 1 further comprising: limiting said x-ray radiation tosaid region of interest in said human patient to a specified amount andless.
 10. The method of claim 1 further comprising: terminating deliveryof said x-ray radiation to said region of interest in said patient whensaid x-ray radiation to said region of interest reaches a predeterminedthreshold amount.
 11. The method of claim 1 further comprising:selecting exposure of said x-ray radiation for each of a plurality ofprojections of said region of interest.
 12. A method for producing anx-ray image of a human patient comprising: producing x-ray radiationfrom an x-ray source; measuring amount of said x-ray radiation passingthrough said human patient and striking a detector; identifying a firstregion in said human patient where signal-to-noise ratio exceeds a firstspecified level; and controlling said x-ray source to selectively limitsaid x-ray radiation to said first region in said human patient to afirst minimum amount required to achieve said first specifiedsignal-to-noise ratio.
 13. The method of claim 12 further comprising:controlling said x-ray source to selectively limit said x-ray radiationto a second region in said human patient to a second minimum amountrequired to achieve a second specified signal-to-noise ratio.
 14. Themethod of claim 12 further comprising: selecting a region of interest insaid human patient; and controlling said x-ray source to limit saidx-ray radiation to said region of interest in said human patient to asecond minimum amount required to achieve a second specifiedsignal-to-noise ratio.
 15. The method of claim 12 further comprising:terminating delivery of said x-ray radiation to said first region insaid patient when said x-ray radiation to said first region reaches apredetermined threshold amount.
 16. A method for producing an x-rayimage of a human patient comprising: producing x-ray radiation from anx-ray source; measuring amount of said x-ray radiation passing throughsaid human patient and striking a detector; identifying a first regionin said human patient where resolution exceeds a first specified level;and controlling said x-ray source to selectively limit said x-rayradiation to said first region in said human patient to a first minimumamount required to achieve said first specified resolution.
 17. Themethod of claim 16 further comprising: controlling said x-ray source toselectively limit said x-ray radiation to a second region in said humanpatient to a second minimum amount required to achieve a secondspecified resolution.
 18. The method of claim 16 further comprising:selecting a region of interest in said human patient; and controllingsaid x-ray source to limit said x-ray radiation to said region ofinterest in said human patient to a second minimum amount required toachieve a second specified resolution.
 19. The method of claim 16further comprising: terminating delivery of said x-ray radiation to saidfirst region in said patient when said x-ray radiation to said firstregion reaches a predetermined threshold amount.